影响皮质型分水岭梗死病情严重程度的因素研究

目的 研究皮质型分水岭梗死病情严重程度的相关影响因素.方法 回顾性分析51例皮质型分水岭梗死患者的临床资料,根据美国国家卫生研究所卒中量表(NIHSS)评分将其病情严重程度分为三组:轻度(NIHSS评分≤3分)、中度(NIHSS评分4～14分)和重度(NIHSS评分≥15分).首先采用单因素分析对可能影响病情严重程度的因素进行分析,然后将与病情严重程度相关的影响因素纳入Logistic回归分析,确定皮质型分水岭梗死患者病情严重程度的独立危险因素.结果 单因素分析显示,年龄、糖尿病、侧支循环、脑缺血溶栓血流分级、血浆溶血磷脂酸水平在不同病情严重程度的皮质型分水岭脑梗死患者中存在统计学差异(均P＜ 0.05).经Logistic回归分析,年龄(OR=0.314,95％CI:0.120-0.781)、侧支循环(OR=0.197,95％CI:0.049-0.780)、脑缺血溶栓血流分级(OR=0.394,95％CI:0.178-0.838)、血浆溶血磷脂酸水平(OR=0.041,95％CI:0.013-0.133)是影响皮质型分水岭梗死病情严重程度的独立危险因素.结论 除年龄外,侧支循环、脑缺血溶栓血流分级、血浆溶血磷脂酸水平能够影响皮质型分水岭梗死的病情严重程度,对上述指标的监测将有助于皮质型分水岭梗死的发病机制探讨和病情评估,进而指导临床治疗.     

一种新的用于宫颈癌粘连细胞图像分割的分水岭算法

目的：探讨一种能有效分割宫颈癌粘连细胞图像的算法,完成各粘连细胞边缘的准确分割。方法利用水平集算法从背景区域中提取目标细胞图像,应用极小值的距离变换算法将图像归一化后与感兴趣区域的梯度图像点乘来抑制无用的梯度信息,然后运用标记分水岭算法对粘连细胞图像进行分割。结果与结论实验结果表明,该算法实现了染色不均的粘连宫颈癌细胞的有效分割,在粘连细胞的边缘建立了较传统的分水岭分割方法更准确的分割线,具有显著的临床应用价值。     

中分子羟乙基淀粉注射液治疗急性脑分水岭梗死的疗效观察

目的 观察中分子羟乙基淀粉注射液治疗急性脑分水岭梗死(CWI)的疗效.方法 随机将100例CWI患者分为中分子羟乙基淀粉注射液治疗组和对照组(每组50例).两组患者均给予改善脑供血、抗血小板等脑梗死常规治疗,治疗组再予以中分子羟乙基淀粉注射液500 ml静脉滴注,每天1次,连续14 d.在治疗前、治疗后第7 d、14 ...     

脑分水岭梗死的不同类型血管狭窄分层与短期预后研究

目的:通过对脑分水岭梗死进行分类、分层研究,了解脑分水岭梗死的血管狭窄对预后的影响。方法:对我院同期收治的脑分水岭梗死患者进行回顾性比较研究。分类:皮质脑分水岭梗死与皮质下脑分水岭梗死;分层:按无血管狭窄、轻、中、重度血管狭窄分层。结果:在95例患者中,皮质脑分水岭梗死脑血管及预后情况:无血管狭窄15例(预后不好1例,预后好14例)、轻度血管狭窄13例(预后不好1例,预后好12例)、中度血管狭窄13例(预后不好3例,预后好10例)、重度血管狭窄13例(预后不好6例,预后好7例);皮质下脑分水岭梗死脑血管及预后情况:无血管狭窄10例(预后不好1例,预后好9例)、轻度血管狭窄10例(预后不好3例,预后好7例)、中度血管狭窄11例(预后不好4例,预后好7例)、重度血管狭窄10例(预后不好8例,预后好2例)。血管狭窄与不良预后关系:不同血管狭窄程度分层X2=18.411,p=0.001(C-CWSIX2=8.204,p=0.042;S-CWSIX2=11.699,p=0.008),不同血管狭窄程度分层影响预后。结论:颅内外血管狭窄与脑分水岭梗死预后有关,不同类型的分水岭梗死有区别,临床上应该进行分层评估血管情况,判断预后。     

脑分水岭梗死与与颅内外血管狭窄的关系

目的:探讨脑分水岭梗死与颅内外血管病变的关系.方法:对65例经头颅MRI检查证实为分水岭脑梗塞的患者行CTA或DSA检查颅内外血管的病变情况.结果:65例脑分水岭梗死患者中颅内外狭窄或闭塞的发生率达90.8％(59/65),在皮质前型病灶中47.3％为颈内动脉狭窄或闭塞所致(9/19),36.8％为大脑中动脉病变所致(...     

Variability of E. coli density and sources in an urban watershed

The objective of this study was to characterize the variability of Escherichia coli density and sources in an urban watershed, particularly to focus on the influences of weather and land use. E. coli as a microbial indicator was measured at fourteen sites in four wet weather events and four dry weather conditions in the upper Blackstone River watershed. The sources of E. coli were identified by ribotyping. The results showed that wet weather led to sharp increases of E. coli densities. Interestingly, an intense storm of short duration led to a higher E. coli density than a moderate storm of long duration (p<0.01). The ribotyping patterns revealed microbial sources were mainly attributed to humans and wildlife, but varied in different weather conditions and were associated with the patterns of land use. Human sources accounted for 24.43% in wet weather but only 9.09% in dry weather. In addition, human sources were more frequently observed in residential zones (>30% of the total sources), while wildlife sources were dominant in open land and forest zones (54%). The findings provide useful information for developing optimal management strategies aimed at reducing the level of pathogens in urban watersheds.     

分水岭脑梗死的临床研究及磁共振特征分析

目的探讨分水岭脑梗死(CWSI)的临床特征、治疗、头部磁共振成像(MRI)及磁共振血管成像(MRA)特征和临床应用价值。方法对我院48例分水岭脑梗死患者回顾分析。结果治愈26例,显著进步12例,好转8例;恶化、死亡各1例;MRI显示皮质前型8例,皮质后型14例,皮质下型24例,混合性2例;MRA显示颈内动脉狭窄或闭塞17处,大脑前动脉或闭塞10处,中动脉狭窄或闭塞8处,大脑后动脉6处,椎基底动脉6处。结论全身血压下降、颈内动脉等脑主干动脉狭窄或闭塞引起分水岭区域血液动力学障碍、血流改变以及微栓塞、Willis环完整性是主要发病原因,磁共振成像对分水岭脑梗死能提供更多的影像学信息。     

Limbic‐predominant age‐related TDP‐43 encephalopathy neuropathologic change and microvascular pathologies in community‐dwelling older persons

Limbic‐predominant age‐related transactive response DNA‐binding protein 43 (TDP‐43) encephalopathy neuropathologic change (LATE‐NC) and microvascular pathologies, including microinfarcts, cerebral amyloid angiopathy (CAA), and arteriolosclerosis are common in old age. A relationship between LATE‐NC and arteriolosclerosis has been reported in some but not all studies. The objectives of this study were to investigate the frequency of co‐occurring LATE‐NC and microvascular pathologies and test the hypothesis that arteriolosclerosis, specifically, is related to LATE‐NC in brains from community‐dwelling older persons. Analyses included 749 deceased participants with completed data on LATE‐NC and microvascular pathology from 3 longitudinal clinical pathologic studies of aging. Given the specific interest in arteriolosclerosis, we expanded the examination of arteriolosclerosis to include not only the basal ganglia but also two additional white matter regions from anterior and posterior watershed territories. Ordinal logistic regression models examined the association of microvascular pathology with LATE‐NC. LATE‐NC was present in 409 (54.6%) decedents, of which 354 (86.5%) had one or multiple microvascular pathologies including 132 (32.3%) with moderate‐severe arteriolosclerosis in basal ganglia, 195 (47.6%) in anterior watershed, and 144 (35.2%) in posterior watershed; 170 (41.5%) with moderate‐severe CAA, and 150 (36.6%) with microinfarcts. In logistic regression models, only posterior watershed arteriolosclerosis, but not other regions of arteriolosclerosis was associated with a higher odds of more advanced LATE‐NC stages (Odds Ratio = 1.12; 95% Confidence Interval = 1.01–1.25) after controlling for demographics, AD, and other age‐related pathologies. Capillary CAA, but not the severity of CAA was associated with an increased odds of LATE‐NC burden (Odds Ratio = 1.71; 95% Confidence Interval = 1.13–2.58). Findings were unchanged in analyses controlling for APOE ε4, vascular risk factors, or vascular diseases. These findings suggest that LATE‐NC with microvascular pathology is a very common mixed pathology and small vessel disease pathology may contribute to LATE‐NC in the aging brain.     

脑分水岭梗死的临床特征（56例资料分析）

目的探讨脑分水岭梗死（CWI）不同于一般脑梗死（GCI）的临床特征。方法对我院同期收治的脑分水岭梗死与其他类型脑梗死进行回顾性比较研究。结果在脑分水岭梗死组56例患者中,行MRA检查47例（83．93％）,颅内血管异常31例（65．96％）,血管异常发生率明显高于一般脑梗死（28．29％）。CWI不同类型之间的NIHSS评分及颅内血管异常情况,无显著统计学差异。在急性期病死率上,CWI组略高于GCI组,在严重心律失常的检出率上,CWI组显著高于GCI组（x2=16．86,P〈0．001）。在进展性卒中的发生率上,CWI组总体上高于GCI组,但两组在统计学上差异无显著性;在CWI亚组中,皮层下型和混合型显著高于GCI组（xz=4．24,P〈0．05）。结论CWI的发生与颅内大血管狭窄或闭塞密切相关,严重心律失常所致血液动力学障碍是CWI发生不容忽视的重要危险因素。CWI不同于一般的小灶性脑梗死,在临床上应重视CWI,尤其是皮质下型CWI。